| Objective: To explore the effect of the implementation of the whole-course nursing intervention in patients with permanent bladder fistula in clinical nursing,and to analyze the impact of the whole-course nursing intervention on the patient’s self-care ability,quality of life and postoperative complications.Methods: In this study,135 patients with permanent bladder fistula were admitted to a hospital from January 2015 to October 2017.After excluding relevant research contraindications,135 permanent patients were treated with parallel control,open and randomized research methods.Patients with bladder fistula were randomly divided into control group and observation group,and completed the Self-care Agency Scale(ESCA)and Short Form 36 Questionnarie(SF-36)scores..The patients in the control group(61 cases)were given routine care,that is,the doctors led the intervention,the nurses evaluated the patient’s condition according to the doctor’s advice,and carried out the health education psychological and physical nursing of the knowledge related to the sputum,and introduced the perioperative precautions and guidance.Perioperative diet,medication,etc.;patients in the observation group(74 cases)were given full-time care,that is,in the organization of nursing staff to learn about the knowledge of permanent bladder fistula,cultivate analytical problems-propose nursing programs-strengthen self-management awareness Form a full-time research nurse team,introduce intervention mechanism based on routine nursing,intervene in the behavior and process of the patient throughout the clinical treatment process,and implement intervention measures to solve problems found during the nursing process.After the end of treatment,the patient’s out-of-hospital personal care guidance was strengthened after the follow-up period,and the outpatient follow-up system was strengthened.The two groups of patients completed follow-up after 6 months of discharge,and completed the Exercise of Self-care Agency Scale(ESCA)and the Short Form 36 Questionnarie(SF-36)scores.The incidence of postoperative complications in the two groups of patients,in order to compare the self-care ability,quality of life assessment and postoperative complication rate of patients with different nursing modes intervention,and then analyze the whole course of care for patients with permanent bladder fistula self The impact of care capacity,quality of life and postoperative complications.Results: Before the intervention,the scores of self-care skills,self-responsibility,self-concept,and health knowledge in the ESCA scale scores of the two groups were not statistically significant,and the total scores were not statistically significant(P>0.05)..After intervention,the ESCA scores of ESCA scores self-care skills,self-responsibility,self-concept,health knowledge level and total score were significantly higher than before intervention,and the difference was statistically significant(P<0.05).Before the intervention,there was no statistically significant difference between the two groups in the SF-36 scale in terms of physiological function,physiological function,physical pain,general health,energy,social function,emotional function,mental health,etc.Statistical significance(P>0.05).After intervention,the physiological function,physiological function,physical pain,general health,energy,social function,emotional function,mental health and total score of the two groups were significantly higher than before the intervention,and the difference was statistically significant(P<0.05).After intervention,the physiological function scores of the observation group(81.26±11.15)were significantly higher than those of the control group(72.56±12.31),and the difference was statistically significant(t=4.26,P<0.05).The physiological function score of the observation group(82.14)±11.87)was significantly higher than the control group(73.32±11.55),the difference was statistically significant(t=4.36,P<0.05).The body pain score of the observation group(78.69±10.56)was significantly higher than that of the control group(72.24±10.69).The difference was statistically significant(t = 3.51,P < 0.05).The overall health score(80.54 ± 12.87)was significantly higher in the observation group than in the control group(72.35 ± 13.47),and the difference was statistically significant(t = 3.59).P < 0.05);The energy score of the observation group(82.85±11.57)was significantly higher than that of the control group(74.26 ± 12.14),and the difference was statistically significant(t=4.18,P<0.05).The social function score of the observation group(75.54±10.56)was significantly higher than the control group(70.33±9.21),comparing The difference was statistically significant(t =3.06,P<0.05).The scores of emotional function(77.54±10.33)in the observation group were significantly higher than those in the control group(72.13±10.65),and the difference was statistically significant(t=2.98,P< 0.05);The mental health score of the observation group(79.62±11.12)was significantly higher than that of the control group(72.58±10.64),the difference was statistically significant(t=5.44,P<0.05).The SF-36 scale score of the observation group The total score(78.46±10.78)was significantly higher than that of the control group(72.52±10.84),and the difference was statistically significant(t=3.18,P<0.05).Patients in the observation group had bladder contracture 1(1.35%),catheter obstruction 1(1.35%),fistula infection 1(1.35%),retrograde infection 1(1.35%),and no catheter prolapse.The total incidence of postoperative complications of bladder fistula was 5.41%.In the control group,bladder contracture 2(3.28%),duct obstruction 2(3.28%),and ductal prolapse 3(4.92%)occurred during follow-up.For example,3(4.92)cases of sputum infection and 2(3.28%)cases of retrograde infection,the total incidence of complications after bladder fistula was 19.67%;the total incidence of complications after observation of ostomy was obvious in the observation group.Compared with the control group,the difference was statistically significant(χ2=6.51,P<0.05).After the intervention of different nursing modes,the patients’ self-care ability,quality of life and postoperative complications were significantly different.The nursing ability and quality of life of the observation group were significantly better than the control group.The incidence of postoperative complications was low,and the correlation analysis showed that there was a good linear relationship between the ESCA scale score and the SF-36 scale score(r=0.9337,P<0.001).Conclusion: The whole-course nursing intervention played a significant role in the clinical nursing of patients with permanent bladder fistula.Compared with the routine nursing intervention model,the ESCA score and SF-36 score of the whole-course nursing intervention group were significantly higher than those of the routine nursing intervention group.After the intervention,the patient’s self-care ability and quality of life improved more significantly,and the incidence of postoperative complications was lower.Therefore,the whole process of nursing care is worthy of clinical application. |
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